"Nearly four years after the [passage of] the HITECH Act, taxpayers should know what we have to show for it," said Rep. Ben Quayle, R-Ariz., chairman of the House Subcommittee on Technology and Innovation.

The subcommittee slated the hearing after eight GOP legislators last month sent letters to the Department of Health and Human Services questioning the merits of the HITECH Act incentive program. They raised concerns about whether Stage 2 requirements for EHR interoperability and secure data exchange are set too low and about whether EHRs contribute to fraudulent billing by providers.

Although four House members in their letter asked HHS to temporarily suspend incentive payments, none of the legislators at the hearing called for halting the program (see: GOP Legislators Question HITECH Merits).

Participation Levels

Farzad Mostashari, M.D., who heads the Office of the National Coordinator for Health IT, told the House panel that the HITECH incentive program is on track to achieve its goal of widespread adoption of EHRs.

"As of September 2012, more than 300,000 - or more than half - of the nation's eligible professionals, as well as over 75 percent of eligible hospitals have registered to participate in the Medicare or Medicaid incentive programs," he said. "Since the program began in January 2011, more than 150,000 eligible professionals and 3,000 hospitals have received an incentive payment, exceeding an FY 2012 target of paying 140,000 providers."

The incentive program is using a multi-stage approach to making progress in rolling out EHRs and promoting the secure exchange of patient information.

Mostashari explained that Stage 1 of the program, which is now under way, focuses "on functionalities that support the electronic capture of data and allow patients to receive electronic copies of their own health information."

The final rules for Stage 2 of the program, which begins in 2014, "focus on increasing standards-based health information exchange between providers and with patients," Mostashari said. "And we anticipate that the Stage 3 rules will continue to advance health IT capabilities by focusing on advanced clinical decision support, improving outcomes, population health management and patient engagement tools."

Addressing concerns about whether EHRs enable fraudulent billing, Mostashari pointed out that a recent New York Times article that reported an uptick in billing by healthcare providers using EHRs was based on research from 2010, "which pre-dates the meaningful use incentive program." (See: EHRs: A Catalyst for Billing Fraud?).

He said HHS is taking steps for "a comprehensive review" of possible inappropriate billing involving EHRs.

Secure Data Exchange

In his testimony, Marc Probst, CIO at Intermountain Health and a member of the HIT Policy Committee that advises ONC, said standards are needed to bolster secure nationwide data exchange.

Probst said the HIT policy and standards committees should "focus on the development and adoption of comprehensive standards across the industry - standards that would improve patient care and allow interoperability between systems and providers."

But in September, ONC dropped plans to develop so-called "rules of the road" for secure nationwide health information exchange, contending that the market is too immature and that issuing HIE regulations now could stunt innovation (see: ONC Backs Off HIE 'Rules of Road').

To help facilitate national health data exchange, Mostashari said, "It's important to make sure that two certified EHRs can talk to each other."